Medical treatment tool

ABSTRACT

A medical treatment tool includes a bendable tube configured to be inserted into a body of a patient; an operating body disposed in the bendable tube and configured to cause bending of the bendable tube, the operating body including: a plurality of divided members that are divided from each other along axially extending edges of adjacent divided members, portions of the divided members forming a tubular structure, and an annular connecting portion, an outer surface of the annular connecting portion being continuous with outer surfaces of the divided members; and a cylindrical member located inside the operating body. Each divided member includes at least one cutout portion formed between the tubular structure and the annular connecting portion. The cylindrical member is in contact with inner surfaces of the divided members.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation filed under 35 U.S.C. § 111(a)claiming the benefit under 35 U.S.C. § 120 of U.S. patent applicationSer. No. 14/219,594, filed Mar. 19, 2014, which is a continuation filedunder 35 U.S.C. § 111(a) claiming the benefit under 35 U.S.C. §§ 120 and365(c) of PCT International Application No. PCT/JP2012/068179 filed onJul. 18, 2012, the entire contents of which are hereby incorporated byreference in their entireties.

BACKGROUND

Technical Field

The present disclosure relates to a medical treatment tool.

Background Art

In the related art, a medical treatment tool in which an insertionsection to be inserted inside the body is configured to be bendable andthe insertion section is configured to bend during operation by anoperating member, such as a wire, is known (for example, refer toJP-UM-A-5-41502).

The medical treatment tool described in JP-UM-A-5-41502 includes a pairof mutually facing narrow plate spring members, a fiber that is arrangedalong an axial direction between plate surfaces of the pair of platespring members and that has a distal portion anchored to a distalportion of each plate spring member, and a jacket member that covers thepair of plate spring members and the fiber. The fiber is configured tobend during operation by moving the pair of plate spring membersmutually in opposite directions.

In a medical treatment tool including an insertion tube having an innercavity, such as a catheter, the insertion tube is made to bend duringoperation by fixing a wire or the like to the distal portion of theinsertion tube.

However, when the wire or the like is fixed to the distal portion of theinsertion tube, the wire or the like can block the inner cavity when theinsertion tube is bent, in which case the inner cavity will not besecured. For this reason, a guide portion, such as a guide hole thatguides the wire or the like, must be provided. The wire or the likeneeds to be held at a predetermined position, which complicates thestructure of the device.

Therefore, there is a need for a medical treatment tool in which aninner cavity of an insertion tube can be secured with a simplestructure.

SUMMARY OF THE INVENTION

In one embodiment, a medical treatment tool includes an insertion tubethat is provided to be bendable and is inserted inside the body of apatient; and an operating body that is provided in the insertion tubeand makes the bending of the insertion tube occur. The operating bodyincludes a plurality of divided members that are divided in acircumferential direction to form a tubular structure in the insertiontube; and a connecting portion that connects distal portions of therespective divided members in an axial direction of the tubularstructure. The divided member includes a cutout portion formed as an endedge in the circumferential direction.

According to this embodiment, the operating body forms the tubularstructure by the plurality of divided members that are divided in thecircumferential direction, and each divided member is provided with thecutout portion formed such that the end edge thereof in thecircumferential direction is cut out. For this reason, the operatingbody can be bent in a low-rigidity portion where the cutout portion isprovided, and the tubular structure of the operating body can bemaintained in a high-rigidity portion where the cutout portion is notprovided. Accordingly, since the operating body can be prevented fromobstructing the inner cavity while enabling the bending of the insertiontube by the operating body, the inner cavity of the insertion tube canbe secured with simple structure.

In one aspect, an inner surface of the insertion tube and an outersurface of the operating body slide on each other at least partially inthe axial direction.

According to this aspect, since the inner surface of the insertion tubeand the outer surface of the operating body slide on each other at leastpartially in the axial direction, the tubular structure of the operatingbody can be enlarged to the extent that the operating body can come intocontact with the inner surface of the insertion tube. Accordingly, sincea large space can be secured inside the operating body, the inner cavityof the insertion tube can be sufficiently secured.

Additionally, as the inner surface of the insertion tube and the outersurface of the operating body slide on each other, the operating body isregulated in the direction of an axial center by the insertion tube.Therefore, the operating body can be reliably arranged, and the innercavity of the insertion tube can be sufficiently secured.

In one aspect, the plurality of divided members slide on each other atthe end edges of the adjacent divided members in the circumferentialdirection.

According to this aspect, since the end edges of the adjacent dividedmembers slide on each other in the circumferential direction, thetubular structure of the operating body can be reliably maintained bythe abutment between the end edges of the divided members in thecircumferential direction, while the relative movement in the axialdirection between the divided members produced during the bending of theinsertion tube is allowed by the sliding. Accordingly, the operatingbody can be prevented from blocking the inner cavity of the insertiontube during the bending of the insertion tube.

In one aspect, a plurality of the cutout portions are provided in theaxial direction of each divided member.

According to this aspect, since the plurality of cutout portions areprovided in the axial direction of each divided member, the operatingbody can be intermittently bent at the positions on the respectivecutout portions. For this reason, since the bent shape of the insertiontube can be changed by changing the arrangement of the cutout portionsin the axial direction, the bent shape of the insertion tube can be setaccording to a path into which the insertion tube is inserted.

In one aspect, the cutout portion is formed so that the circumferentialdimension of the portion of each divided member where the cutout portionis provided becomes gradually smaller toward the axial direction.

According to this aspect, since the portion of each divided member wherethe cutout portion is provided becomes gradually narrow toward the axialdirection, the rigidity of the portion can be changed according to thedegree of narrowness of the portion. For this reason, since the bentshape of the insertion tube can be changed by changing the degree ofnarrowness of the portion, the bent shape of the insertion tube can beset according to a path into which the insertion tube is inserted.

In one aspect preferably, each divided member includes a movementregulating portion that regulates the relative movement of the adjacentdivided members in the axial direction to a predetermined movementamount.

According to this aspect, since the movement regulating portion thatregulates the relative movement of the adjacent divided members in theaxial direction to a predetermined amount is provided, the bendingamount of the insertion tube can be regulated to a predetermined amount,and the bending limit of the insertion tube can be defined.

In one aspect, the medical treatment tool further includes an annularmember provided inside the operating body.

According to this aspect, since the annular member is provided insidethe operating body, the tubular structure of the operating body can bemaintained by the annular member even when there is a gap between theend edges of the adjacent divided members in the circumferentialdirection. On the other hand, when there is no gap between the end edgesof the adjacent divided members in the circumferential direction, thetubular structure of the operating body can be more reliably maintainedby the annular member. Accordingly, the inner cavity of the insertiontube can be secured irrespective of the presence or absence of the gapbetween the end edges of the divided members.

In one aspect, the medical treatment tool further includes a dilationbody that is provided at an outer periphery of the insertion tube anddilates in a radial direction of the insertion tube.

According to this aspect, since the dilation body can be dilated in thenarrow segment in the body, the narrow segment can be dilated andtreated.

In one aspect, the medical treatment tool further includes a dilationbody that is removably inserted into the tubular structure of theoperating body and dilates in a radial direction of the insertion tube.

According to this aspect, since the dilation body is removably insertedinto the tubular structure of the operating body, it is not necessary toprovide the dilation body at the outer periphery of the insertion tube.For this reason, the insertion tube can be easily inserted inside thebody in the dilation treatment of narrow segment.

In one aspect, the medical treatment tool is a treatment tool fortreating rhinosinusitis.

According to this aspect, since the inner cavity of the insertion tubecan be secured with simple structure in the medical treatment tool usedfor the treatment of the paranasal sinus, the manufacturing costs of thetreatment tool used for the paranasal sinus can be reduced, an insert,such as an endoscope required for the treatment of the paranasal sinus,can be inserted into the insertion tube, or a fluid, such as aphysiological salt solution, can be carried via the insertion tube.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 is a plan view of a medical treatment tool related to a firstembodiment of the invention.

FIG. 2 is a partial cross-sectional side view showing an insertion tubeof the medical treatment tool of FIG. 1.

FIG. 3 is a partial cross-sectional side view showing the insertion tubeof the medical treatment tool of FIG. 1.

FIG. 4 is a perspective view of an operating body of the medicaltreatment tool of FIG. 1.

FIG. 5 is a side view showing a bent state of the insertion tube of themedical treatment tool of FIG. 1.

FIG. 6 is a side view of an insertion tube of a medical treatment toolrelated to a second embodiment of the invention.

FIG. 7 is a side view of an insertion tube of a medical treatment toolrelated to a third embodiment of the invention.

FIG. 8 is a side view of an insertion tube of a medical treatment toolrelated to a fourth embodiment of the invention.

FIG. 9 is a side view of an insertion tube of a medical treatment toolrelated to a fifth embodiment of the invention.

FIG. 10 is a side view of an insertion tube of a medical treatment toolrelated to a sixth embodiment of the invention.

FIG. 11 is a side view of an insertion tube of a medical treatment toolrelated to a modification example of the sixth embodiment of theinvention.

FIG. 12 is a side view of an insertion tube of a medical treatment toolrelated to a seventh embodiment of the invention.

FIG. 13 is a side view of an insertion tube of a medical treatment toolrelated to an eighth embodiment of the invention.

FIG. 14 is a plan view of a medical treatment tool related to a ninthembodiment of the invention.

DETAILED DESCRIPTION

Hereinafter, respective embodiments of the invention will be describedwith reference to the drawings.

In the embodiments following the second embodiment, the same componentmembers as component members described in the first embodiment andcomponent members having the same functions as the component members ofthe first embodiment will be designated using the same referencenumerals as the component members of the first embodiment, and thedescriptions thereof will be omitted or simplified.

First Embodiment

In FIG. 1, a medical treatment tool 1 related to the present embodimentincludes a hub 2, an insertion tube 3 of which at least a portion isprovided to be bendable and that is inserted inside the body of apatient, an operating body 4 (FIGS. 2 and 3) that is provided in theinsertion tube 3 to operate bending of the insertion tube 3, and andilation body 5 that is provided at an outer periphery of the insertiontube 3 and is dilated in the radial direction of the insertion tube 3.

The hub 2 includes an introduction path 21 that allows the inner cavityof the insertion tube 3 and the outside to communicate with each otherand is configured so as to be capable of introducing a treatment tool,such as an endoscope, into the inner cavity of the insertion tube 3, afluid carrying path 22 that is provided to branch from the introductionpath 21 and is configured so as to be capable of carrying a fluid, suchas a physiological salt solution, into the body and capable of carryinga fluid in the body to the outside, and a position fixture 23 that isrotatably provided at the hub 2 and fixes the bending position of theinsertion tube 3 by the operating body 4.

The insertion tube 3, as shown in FIGS. 2 and 3, includes a rigid tube31 that has a proximal portion connected to the hub 2, and a flexibletube 32 connected to a distal portion of the rigid tube 31. The flexibletube 32 includes a plurality of tubular bodies 33 and 34, and thetubular bodies 33 and 34 and the rigid tube 31 are coupled together inan axial direction so as to be mutually rotatable. Since an outerperiphery of the flexible tube 32 is brought into close contact with andcovered with a tubular member 35 having flexibility, such as an elasticmember, a fluid sent to the dilation body 5 does not flow into theflexible tube 32 from a gap between each tubular body 33 or 34 and therigid tube 31.

The respective tubular bodies 33 and 34 include rotating shaft portions331 and 341 protruding in coupling directions (axial directions of therespective tubular bodies 33 and 34) from one-side end edges in thecoupling directions.

On the other hand, the rigid tube 31 and the tubular member 34 includerotating supporting portions 311 and 342 formed such that the other-sideend edges thereof in the coupling directions (the axial directions ofthe rigid tube 31 and the tubular member 34) retreat, and the rotatingshaft portions 331 and 341 of the respective tubular bodies 33 and 34are supported by the rotating supporting portions 311 and 342.

In addition, a pair of the rotating shaft portion 331 or 341 and therotating supporting portion 311 or 342 are provided at positions thatare symmetrical to each other with respect to the central axes of therigid tube 31 and each tubular body 33 or 34.

The insertion tube 3 as described above is obtained, for example, byperforming laser processing on a circular tubular member made ofstainless steel. When the laser processing is used, the insertion tube 3in a state where the rigid tube 31 and the respective tubular bodies 33and 34 are coupled to each other can be easily obtained by simplycutting the circular tubular member with a laser. In addition, thematerial and manufacturing method of the insertion tube 3 are notlimited to the above, and arbitrary materials and manufacturing methodscan be used.

The operating body 4, as shown also in FIG. 4, includes a plurality ofdivided members 40 that are divided in a circumferential direction inthe insertion tube 3 to form a tubular structure, and a connectingportion 41 that is formed in an annular shape and connects the distalportions of the respective divided members 40 in an axial direction ofthe tubular structure.

All of the plurality of divided members 40 are formed in the same shape.Each divided member 40 includes cutout portions 43 formed such that endedges 42 of the divided member 40 in the circumferential direction arecut out, a broad portion 44 that is a portion in which the cutoutportions 43 of the divided member 40 are not provided and that has ashape such that a cylindrical member is divided in the circumferentialdirection, and a narrow portion 45 in which the cutout portions 43 ofthe divided member 40 are provided and that is formed so as to benarrower than the broad portion 44 by the cutout portions 43.

The cutout portions 43 are formed such that the end edges 42 on bothsides in the circumferential direction are cut out in the same shape atthe same position in the axial direction. In addition, in the presentembodiment, the cutout portions 43 are formed at a portion between theconnecting portion 41 and the broad portion 44.

The broad portion 44 is formed in a shape such that the cylindricalmember is equally divided into two in the circumferential direction. Theend edges 42 of the broad portion 44 in the circumferential directionare formed linearly, and slide on the end edges 42 of the adjacent ofthe divided member 40 in the axial direction. That is, the respectivedivided members 40 are formed so that the end edges 42 in thecircumferential direction except the cutout portions 43 slide on eachother in the axial direction.

The narrow portion 45 is provided at a substantially middle position ofeach divided member 40 in the circumferential direction so as to extendin the axial direction, and is formed such that the dimension thereof inthe circumferential direction is constant. The narrow portions 45 of therespective divided members 40 are provided at positions that face eachother across the center of the tubular structure.

In the above operating body 4, one divided member 40 and the otherdivided member 40 relatively move in the axial direction, whereby thetwo narrow portions 45 that face each other are bent within a planepassing through the two narrow portions 45 to bend the flexible tube 32.For this reason, the operating body 4 is arranged in the insertion tube3 so that the narrow portions 45 are located between the mutually facingrotating shaft portions 331 and 341 of the flexible tube 32, that is, sothat the cutout portions 43 are located at the positions of the rotatingshaft portions 331 and 341.

Here, it is desirable that the external diameter of the operating body 4be increased in order to increase the diameter of the inner cavity ofthe insertion tube 3. For this reason, the operating body 4 is adaptedto have a size such that an outer surface thereof comes into contactwith an inner surface of the insertion tube 3.

Moreover, it is desirable to make the thickness of the operating body 4as small as possible due to the same reason. For this reason, thethickness of the operating body 4 is set to about 0.05 to 1.0 [mm], anddesirably about 0.075 to 0.3 [mm].

Such an operating body 4 is easily obtained, for example, by performinglaser processing on the circular tubular member made of stainless steel,similar to the case of the insertion tube 3. In addition, the materialand manufacturing method of the operating body 4 are not limited to theabove, and arbitrary materials and manufacturing methods can also beused.

The dilation body 5 is made of a flexible material, such as a polymer.The inside of the dilation body 5 communicates with a flow channel 51provided around the insertion tube 3, and a fluid is introduced into thedilation body 5 via the flow channel 51 so that the dilation body 5 isdilated in the radial direction.

In the above medical treatment tool 1, the position fixture 23 isrotated with respect to the hub 2 when the flexible tube 32 of theinsertion tube 3 is bent. If the position fixture 23 is rotated, asshown in FIG. 5, one divided member 40 of the operating body 4 is pushedto the distal side, and the other divided member 40 is pulled to theproximal side. For this reason, one divided member 40 and the otherdivided member 40 relatively move in the axial direction while the endedges 42 of the adjacent divided members 40 in the circumferentialdirection slide on each other in the axial direction. As a result, theflexible tube 32 can be bent as the narrow portions 45 of the operatingbody 4 are bent while the outer surface of the operating body 4 slideson the inner surface of the insertion tube 3. The bending position ofthe flexible tube 32 in this case can be fixed by the position fixture23.

Next, the use procedure and operation of the medical treatment tool 1when the medical treatment tool 1 is used as a treatment tool forrhinosinusitis treatment will be described as an example of use of themedical treatment tool 1.

First, an operator inserts the insertion tube 3 of the medical treatmenttool 1 into a nostril. In this case, by inserting imaging means, such asan endoscope, into the insertion tube 3, the operator can insert theinsertion tube 3 while confirming a state within an insertion path, onthe basis of image information acquired by the imaging means.

If the dilation body 5 of the inserted insertion tube 3 is guided to anatural ostium of the paranasal sinus narrowed by rhinosinusitis, theoperator introduces a fluid into the dilation body 5 via the flowchannel 51, and dilates the dilation body 5, thereby dilating andtreating a narrow segment of the natural ostium. In addition, if theinsertion tube 3 is retreated a little after the dilation body 5 iscontracted, whether the narrow segment was dilated can be confirmed fromthe image information acquired by the imaging means.

Also, if a fluid or sticky substance, such as mucous, remains in theparanasal sinus, the insertion tube 3 can be inserted into the paranasalsinus from the dilated natural ostium, and the fluid or sticky substancecan be carried via the inner cavity of the insertion tube 3 and thefluid carrying path 22. Additionally, by introducing a washing fluid,such as a physiological salt solution, into the fluid carrying path 22,the fluid can also clean the inside of the paranasal sinus.

Advantages of the present embodiment may include the following.

That is, the operating body 4 forms the tubular structure by theplurality of divided members 40 that are divided in the circumferentialdirection, and each divided member 40 is provided with the cutoutportions 43 formed such that the end edges 42 thereof in thecircumferential direction are cut out. For this reason, the operatingbody 4 can be bent in low-rigidity portions where the cutout portions 43are provided, and the tubular structure of the operating body 4 can bemaintained in high-rigidity portions where the cutout portions 43 arenot provided. Accordingly, since the operating body 4 can be preventedfrom obstructing the inner cavity while enabling the bending of theinsertion tube 3 by the operating body 4, the inner cavity of theinsertion tube 3 can be secured with simple structure.

Additionally, since the inner surface of the insertion tube 3 and theouter surface of the operating body 4 slide on each other at leastpartially in the axial direction, the tubular structure of the operatingbody 4 can be enlarged to the extent that the operating body 4 can comeinto contact with the inner surface of the insertion tube 3.Accordingly, since a large space can be secured inside the operatingbody 4, the inner cavity of the insertion tube 3 can be sufficientlysecured.

Additionally, since the end edges 42 of the adjacent divided members 40in the circumferential direction slide on each other, the tubularstructure of the operating body 4 can be reliably maintained from theabutment between the end edges 42 of the divided members 40 in thecircumferential direction, while the relative movement in the axialdirection between the divided members 40 produced during the bending ofthe insertion tube 3 is allowed by the sliding. Accordingly, theoperating body 4 can be prevented from blocking the inner cavity of theinsertion tube 3 during the bending of the insertion tube 3.

Additionally, since the dilation body 5 can be dilated in the narrowsegment in the body, the narrow segment can be dilated and treated.

Second Embodiment

Next, a second embodiment of the invention will be described withreference to FIG. 6.

A medical treatment tool 1A of the present embodiment, as shown in FIG.6, is different from the tool in the first embodiment in terms of thestructure of an insertion tube 3A and a plurality of cutout portions 43Aand 46A provided in the axial direction of an operating body 4A.

The insertion tube 3A is made of a material having flexibility, such asresin or rubber, as a whole, and is configured so that an arbitraryportion is bendable.

On the other hand, in the operating body 4A, a plurality of cutoutportions 43A and 46A are provided in the axial direction of each dividedmember 40A. In the present embodiment, the cutout portion 43A of eachdivided member 40A that is located furthest toward the distal end isformed to be long in the axial direction compared to the plurality ofother cutout portions 46A according to the length of the dilation body 5in the axial direction.

Additional advantages of the second embodiment may include thefollowing.

That is, since the plurality of cutout portions 43A and 46A are providedin the axial direction of each divided member 40A, the operating body 4Acan be intermittently bent at the positions of the respective cutoutportions 43A and 46A. For this reason, since the bent shape of theinsertion tube 3A can be changed by changing the arrangement of thecutout portions 43A and 46A in the axial direction, the bent shape ofthe insertion tube 3A can be set according to a path into which theinsertion tube 3A is inserted.

Third Embodiment

Next, a third embodiment of the invention will be described withreference to FIG. 7.

A medical treatment tool 1B of the present embodiment, as shown in FIG.7, is different from the first embodiment in terms of the structure ofan insertion tube 3B and the number of divisions of divided members 40Bof an operating body 4B.

The insertion tube 3B is configured similar to the second embodiment,and is made of a material having flexibility, such as resin or rubber,as a whole.

The operating body 4B is equally divided into four sections that form atubular structure in the circumferential direction. That is, theoperating body 4B includes four divided members 40B and a connectingportion 41 that connects distal portions of the divided members 40B.Since the other configuration of the operating body 4B is the same asthat of the first embodiment, the additional description thereof will beomitted.

Additional advantages of the third embodiment may include the following.

That is, since the operating body 4B includes the divided members 40Bthat are divided into four sections in the circumferential direction,the operating body 4B can be bent in four directions. For this reason,since the insertion tube 3B can be more flexibly bent, the followabilityof the insertion tube 3B with respect to a path into which the insertiontube 3B is inserted can be improved.

Fourth Embodiment

Next, a fourth embodiment of the invention will be described withreference to FIG. 8.

A medical treatment tool 1C of the present embodiment, as shown in FIG.8, is different from the first embodiment in terms of the structure ofan insertion tube 3C and the number and shape of cutout portions 43C1,43C2, 46C1, and 46C2 provided in the axial direction of an operatingbody 4C.

The insertion tube 3C is configured similar to the second embodiment,and is made of a material having flexibility, such as resin or rubber,as a whole.

The operating body 4C includes four divided members 40C1 and 40C2 ineach of which two of the cutout portions 43C1, 43C2, 46C1, or 46C2 areprovided in the axial direction, and the connecting portion 41 thatconnects distal portions of the divided members 40C1 and 40C2. Here,when two divided members 40C1 and 40C2 that face each other, are madeinto one set, the amounts of cutouts, in the circumferential direction,of the cutout portions 43C1 of the divided members 40C1 of one set aremade larger than these of the cutout portions 43C2 of the dividedmembers 40C2 of the other set, on the distal side of the operating body4C. Additionally, on the proximal side of the operating body 4C, theamounts of cutouts, in the circumferential direction, of the cutoutportions 46C2 of the divided members 40C2 of the other set are madelarger than these of the cutout portions 46C1 of the divided members40C1 of the other set.

By virtue of such a configuration, on the distal side of the operatingbody 4C, the circumferential dimensions of narrow portions 45C1 of thedivided members 40C1 of the one set are made smaller than these ofnarrow portions 45C2 of the divided members 40C2 of the other set.Additionally, on the proximal side of the operating body 4C, thecircumferential dimensions of narrow portions 47C2 of the dividedmembers 40C2 of the other set are made smaller than these of narrowportions 47C1 of the divided members 40C1 of the one set. Also, in therespective divided members 40C1 and 40C2, the circumferential dimensionsof the narrow portions 45C1 and 45C2 on the distal side are madedifferent from the circumferential dimensions of the narrow portions47C1 and 47C2 on the proximal side.

Additional advantages of the fourth embodiment may include thefollowing.

That is, positions where the narrow portions 45C1 having smallercircumferential dimensions compared to the narrow portions 45C2 on thedistal side of the operating body 4C are provided, and positions wherethe narrow portions 47C2 having smaller circumferential dimensionscompared to these of the narrow portions 47C1 on the proximal side ofthe operating body 4C are provided are different from each other. Forthis reason, bending directions can be made different on the distal sideand proximal side of the operating body 4C.

Fifth Embodiment

Next, a fifth embodiment of the invention will be described withreference to FIG. 9.

A medical treatment tool 1D of the present embodiment, as shown in FIG.9, is different from the first embodiment in terms of the shape of anarrow portion 45D of an operating body 4D, that is, the shape of cutoutportions 43D of divided members 40D.

Specifically, the cutout portions 43D are formed so that thecircumferential dimension of the narrow portion 45D becomes graduallysmaller toward a distal portion in the axial direction. For this reason,the rigidity of the narrow portion 45 becomes gradually smaller towardthe distal portion in the axial direction.

Additional advantages of the fifth embodiment may include the following.

That is, since the portion of each divided member 40D where the cutoutportions 43D are provided, that is, the narrow portion 45D becomesgradually narrow toward the axial direction, the rigidity of the portioncan be changed according to the degree of narrowness of the portion. Forthis reason, since the bent shape of the insertion tube 3 can be changedby changing the degree of narrowness of the portion, the bent shape ofthe insertion tube 3 can be set according to a path into which theinsertion tube 3 is inserted.

Additionally, since the bending starting position of the operating body4D during a bending operation can be changed by changes in the rigidityof the narrow portion 45D, the bending starting position of theinsertion tube 3A can be set depending on the shape of the narrowportion 45D, that is, the shape of the cutout portions 43D. In addition,a portion that becomes gradually narrow may be provided not only at thedistal portions of the cutout portions 43D but also at middle portions,proximal portions, or the like.

In the case of the present embodiment, since the rigidity of the narrowportion 45D becomes small toward a distal portion, the amount of bendingbecomes small at a proximal portion of the narrow portion 45D andbecomes larger on the distal portion. For this reason, the bent state ofthe narrow portion 45D can be changed according to a position in theaxial direction, and thereby, the bent shape of the insertion tube 3 canbe changed.

Sixth Embodiment

Next, a sixth embodiment of the invention will be described withreference to FIG. 10.

A medical treatment tool 1E of the present embodiment, as shown in FIG.10, is different from the first embodiment in that a movement regulatingportion 6 is provided at end edges 42 of divided members 40E1 and 40E2in an operating body 4E.

Specifically, the end edge 42 of the broad portion 44 of one dividedmember 40E1 is provided with a convex portion 48E protruding in thecircumferential direction from the end edge 42. Additionally, the endedge 42 of the broad portion 44 of the other divided member 40E2 isprovided with a concave portion 49E that is formed in a concave shape inthe circumferential direction from the end edge 42 and has the convexportion 48E accommodated therein. Also, the movement regulating portion6 is constituted by the convex portion 48E and the concave portion 49E.

Additional advantages of the sixth embodiment may include the following.

That is, since the movement regulating portion 6 that regulates therelative movement of the adjacent divided members 40E1 and 40E2 in theaxial direction to a predetermined amount is provided, the bendingamount of the insertion tube 3 can be regulated to the predeterminedamount, and the bending limit of the insertion tube 3 can be defined.

In addition, as shown in FIG. 11, as end edges of the convex portion 48Eand the concave portion 49E in the axial direction are obliquely formed,the regulation of the relative movement of the divided members 40E1 and40E2 can be performed not only by the abutment resistance of the convexportion 48E and the concave portion 49E but also by thediameter-enlargement resistance between the operating body 4E and theinsertion tube 3 by the diameter enlargement of the operating body 4E.As a result, the bending limit of the insertion tube 3 can be morereliably defined, and the inner cavity of the insertion tube 3 can besufficiently secured.

Seventh Embodiment

Next, a seventh embodiment of the invention will be described withreference to FIG. 12.

A medical treatment tool 1F of the present embodiment, as shown in FIG.12, is different from the first embodiment in that a cylindrical member7 as an annular member is provided inside an operating body 4F and inthat the end edges 42 of adjacent divided members 40F in thecircumferential direction do not slide on each other.

The cylindrical member 7 has an external diameter that is large enoughto have a gap G between the end edges 42 of the adjacent divided members40F, and is provided inside the operating body 4F in the rigid tube 31.In addition, in the present embodiment, the cylindrical member 7 isattached to an inner surface of one divided member 40F. As a result,during the bending of the insertion tube 3, an inner surface of theother divided member 40F slides on an external surface of thecylindrical member 7, while the end edges 42 of the adjacent dividedmembers 40F do not slide on each other.

Additional advantages of the seventh embodiment may include thefollowing.

That is, since the cylindrical member 7 is provided inside the operatingbody 4F, the tubular structure of the operating body 4F can bemaintained by the cylindrical member 7 even when there is the gap Gbetween the end edges 42 of the adjacent divided members 40F in thecircumferential direction. On the other hand, when there is no gap Gbetween the end edges 42 of the adjacent divided members 40F in thecircumferential direction, the tubular structure of the operating body4F can be more reliably maintained by the cylindrical member 7.Accordingly, the inner cavity of the insertion tube 3 can be securedirrespective of the presence or absence of the gap G between the endedges 42 of the divided members 40F.

Eighth Embodiment

Next, an eighth embodiment of the invention will be described withreference to FIG. 13.

A medical treatment tool 1G of the present embodiment, as shown in FIG.13, is different from the seventh embodiment in that a coil spring 8 asan annular member is provided inside an operating body 4G.

The coil spring 8 has an external diameter that is large enough to havethe gap G between the end edges 42 of adjacent divided members 40G andis provided from the connecting portion 41 of the operating body 4G tothe broad portion 44 thereof.

Additional advantages of the eighth embodiment may include thefollowing.

That is, since the coil spring 8 has flexibility, the spring can bearranged at any position of the rigid tube 31 and the flexible tube 32,and can be provided at arbitrary positions of the insertion tube 3.

Ninth Embodiment

Next, an eighth embodiment of the invention will be described withreference to FIG. 14.

A medical treatment tool 1H of the present embodiment, as shown in FIG.14, is different from the first embodiment in that a balloon catheter 9having a dilation body 91 is provided so as to be capable of beinginserted into or pulled out of the tubular structure of the operatingbody in the insertion tube 3, and in that the dilation body 5 (FIG. 1)is not provided at an outer periphery of the insertion tube 3.

Additional advantages of the ninth embodiment may include the following.

That is, since the dilation body 91 is removably inserted into thetubular structure of the operating body 4, it is not necessary toprovide the dilation body 5 (FIG. 1) at the outer periphery of theinsertion tube 3. For this reason, the insertion tube 3 can be easilyinserted inside the body in the dilation treatment of narrow segment.

In addition, the invention is not limited to the aforementionedembodiments, and alternations, improvements, or the like within thescope and the object of the invention will be included in the invention.

For example, although the insertion tube 3 and the operating body 4 aremade of metal, such as stainless steel, the insertion tube and theoperating body may be made of other members, such as resin and othermetals as long as flexibility is provided.

Additionally, arbitrary insertion tubes can be used as the insertiontubes 3 and 3A to 3C as long as at least a portion is provided to bebendable. For example, in the aforementioned embodiments, the insertiontubes 3A to 3C that are bendably configured as a whole may be usedinstead of the insertion tube 3 including the flexible tube 32, or viceversa. Additionally, an insertion tube constituted by the flexible tube32 as a whole may be used.

Moreover, the insertion tubes 3 and 3A to 3C do not need to becylindrical, and may have a polygonal cross-section.

In the aforementioned embodiments, the operating bodies 4 and 4A to 4Ginclude the divided members 40 and 40A to 40G that are divided into twoor four. However, the number of divisions of the divided members is notlimited to this if the number is equal to or more than two.

In the operating bodies 4 and 4A to 4G, the shape of the connectingportion 41 is not limited to those of the aforementioned embodiments.For example, the connecting portion may be formed in a tubular or linearfashion. Additionally, a plurality of linear members may be stretchedbetween the respective divided members 40 and 40A to 40G so as tointersect the central axes of the tubular structures of the operatingbodies 4 and 4A to 4G, and may constitute the connecting portion 41.

In the aforementioned embodiments, the dilation bodies 5 and 91 areprovided. However, the dilation bodies 5 and 91 are not indispensableexcept for a case where dilation treatment of narrow segment isperformed, and the medical treatment tools 1 and 1A to 1G may beconfigured without providing the dilation bodies 5 and 91.

In the aforementioned embodiments, when the cylindrical member 7 or thecoil spring 8 as an annular member is provided inside the operatingbodies 4F and 4G, the gap G is allowed between the end edges 42 of theadjacent divided members 40F and 40G. However, a configuration may beadopted in which the end edges 42 of the adjacent divided members 40 and40A to 40G slide on each other after the annular members are providedinside the operating bodies 4 and 4A to 4G. As a result, the tubularstructures of the operating bodies 4 and 4A to 4G can be more reliablymaintained.

Additionally, the annular members are not limited to the cylindricalmember 7 and the coil spring 8. For example, a plurality of fine linearannular members may be provided in the axial direction.

In the aforementioned embodiments, the medical treatment tools 1 and 1Ato 1H are used for paranasal sinus observation, dilation of narrowsegment produced in a natural ostium of the paranasal sinus, ortreatment of the rhinosinusitis. However, the medical treatment toolsmay also be used for observation or treatment of other regions in thebody.

Embodiment of the invention can be used in medical treatment tools, suchas tools for treatment of a paranasal sinus. Embodiments of theinvention can also be used for other medical examinations, or fortreatments that do not accompany a surgical procedure.

What is claimed is:
 1. A medical treatment tool comprising: a bendabletube configured to be inserted into a body of a patient; an operatingbody disposed in the bendable tube and configured to cause bending ofthe bendable tube, the operating body including: a plurality of dividedmembers that are divided from each other along axially extending edgesof adjacent divided members, portions of the divided members forming atubular structure, and an annular connecting portion, an outer surfaceof the annular connecting portion being continuous with outer surfacesof the divided members; and a cylindrical member located inside theoperating body, wherein each divided member comprises a cutout portionformed between the tubular structure and the annular connecting portion,and wherein the cylindrical member is in contact with inner surfaces ofthe divided members.
 2. The medical treatment tool according to claim 1,wherein: the plurality of divided members comprises a first dividedmember and a second divided member; and an inner surface of the firstdivided member is attached to the cylindrical member, and an innersurface of the second divided member is configured to slide against thecylindrical member.
 3. The medical treatment tool according to claim 1,wherein the cylindrical member has an external diameter such that a gapis located between the axially extending edges of the divided members.4. The medical treatment tool according to claim 1, wherein an innersurface of the bendable tube and an outer surface of the operating bodyare configured to slide against each other in the axial direction. 5.The medical treatment tool according to claim 1, wherein the axiallyextending edges of the plurality of divided members are configured toslide against each other.
 6. The medical treatment tool according toclaim 1, wherein each divided member comprises a plurality of additionalcutout portions.
 7. The medical treatment tool according to claim 1,further comprising a dilation body that is located at an outer peripheryof the bendable tube and is configured to dilate in a radial directionof the bendable tube.
 8. The medical treatment tool according to claim7, wherein the dilation body is a balloon extending around the cutoutportion of each divided member.
 9. The medical treatment tool accordingto claim 1, wherein the medical treatment tool is a treatment toolconfigured for rhinosinusitis treatment.